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Characteristics na Clinicians (n = 11) Interview length, minutes, range (mean) 29–55 (43) Professional role GP 7 Advanced nurse practitioner 2 Clinical pharmacist 1 Physician associate 1 Years in the current role, range (median) 2.5–40 (6) Years of clinical experience, range (median) 8.5–47 (16) Sex Female 7 Male 4 Patients (n = 19) Focus group length, minutes 77 Interview length, minutes, range (mean) 25–51 (39) Sex Female 18 Male 1 Age, years, range (median) 21–81 (43) Self-reported experience of UTIsb Females with recurrent and/or chronic UTIs (currently or at some point in life) 14 Females with 1–3 uncomplicated UTIs in the past year (without history of recurrent and/or chronic UTIs) 4 Male who experienced one UTI 1 aUnless otherwise stated. bSupplementary Boxes S1 and S2 contain a brief summary of each patient's experience of UTIs. UTIs = urinary tract infections.
Themes Reasons to be amenable to the SAWB advice Reasons to be concerned or sceptical about the SAWB advice Change in evidence, guidelines, and education required for SAWB Medicine evolves (antibiotic courses are not always evidence based and have shortened), so open to SAWB if evidence and guidelines change (C)
Antibiotic courses seem arbitrary — clinicians prescribe different courses and many patients do not take full courses anyway (C)
SAWB is unfamiliar and at odds with the ingrained advice to complete antibiotic courses (C and P)
Current approach to antibiotics influences attitudes to SAWB SAWB seen as more appropriate and beneficial with longer antibiotic courses for UTIs or other infections (C and P), especially as it is already given with longer courses (C)
SAWB advice already given or used in recurrent UTIs (C and P)
3-day antibiotics for UTIs are already short so SAWB would be less or not relevant for UTIs (C and P)
SAWB with short courses for UTIs would have little impact or benefit so it is not a priority (C)
Patients with experience of recurrent and/or complicated UTIs perceived current courses as already too short so were against stopping even earlier (P)
Balancing risks and benefits of SAWB is needed Would consider SAWB if evidence shows it is safe and beneficial (C and P)
SAWB may help reduce antibiotic side effects (C and P) and antimicrobial resistance (C)
SAWB may be more suitable for other infections than UTIs where risks of recurrence and/or complications are lower (P)
SAWB may lead to recurrence, complications, and antimicrobial resistance (C and P)
Participants with recurrent and/or chronic UTIs were particularly concerned about SAWB causing resistant UTIs (P)
Importance of effective communication and personalisation of SAWB SAWB may help empower patients as part of shared decision making (C and P)
SAWB advice more acceptable from a trusted clinician and when personalised (P)
Unsure how SAWB should be best formulated and that it may be unclear to patients when to stop antibiotics (C and P)
Unsure and concerned about what happens with unused or leftover antibiotics (C and P)
SAWB inappropriate for those perceived to be unable to make treatment decisions (C and P)
C = views expressed by clinicians. P = views expressed by patients. SAWB = stopping antibiotics when better. UTI = urinary tract infection.
Supplementary Data
- Borek_BJGPO.2022.0170_Supp.pdf -
Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.
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